Vemurafenib in patients with BRAF(V600) mutation-positive melanoma with symptomatic brain metastases: final results of an open-label pilot study.

BACKGROUND & AIM: Brain metastases are frequent in patients with metastatic melanoma, indicating poor prognosis. We investigated the BRAF kinase inhibitor vemurafenib in patients with advanced melanoma with symptomatic brain metastases. METHODS: This open-label trial assessed vemurafenib (960mg twice a day) in patients with BRAF(V600) mutation-positive metastatic melanoma with non-resectable, previously treated brain metastases. The primary end-point was safety. Secondary end-points included best overall response rate, and progression-free and overall survival. RESULTS: Twenty-four patients received vemurafenib for a median treatment duration of 3.8 (0.1-11.3) months. The majority of discontinuations were due to disease progression (n=22). Twenty-three of 24 patients reported at least one adverse event (AE). Grade 3 AEs were reported in four (17%; 95% confidence interval [CI], 4.7-37.4%) patients and included cutaneous squamous cell carcinoma in four patients. Median progression-free survival was 3.9 (95% CI, 3.0-5.5) months, and median survival was 5.3 (95% CI, 3.9-6.6) months. An overall partial response (PR) at both intracranial and extracranial sites was achieved in 10 of 24 (42%; 95% CI, 22.1-63.4) evaluable patients, with stable disease in nine (38%; 95% CI, 18.8-59.4) patients. Of 19 patients with measurable intracranial disease, seven (37%) achieved >30% intracranial tumour regression, and three (16%; 95% CI, 3.4-39.6%) achieved a confirmed PR. Other signs of improvement included reduced need for corticosteroids and enhanced performance status. CONCLUSIONS: Vemurafenib can be safely used in patients with advanced symptomatic melanoma that has metastasised to the brain and can result in meaningful tumour regression.

Dossiers commentés en imagerie digestive.

Objectifs : Présenter des cas cliniques d'imagerie d'urgences en imagerie abdominale. Détailler le raisonnement qui conduit à la liste des hypothèses et comment le diagnostic final peut être retenu. Définir en quoi ces dossiers sont intéressants, soit du fait de leur présentation caractéristique, soit en raison de leur caractère inhabituel mais pas exceptionnel, soit parce qu'ils ont conduit à des erreurs d'interprétation lorsqu'ils se sont présentés.

09033-018 Camp Creek Final Report

Growing Green Communities is strongly committed to improving the quality of Camp Creek and its watershed by reducing soil loss, which will benefit landowners by preserving their topsoil and improve the water quality of Camp Creek by reducing sediment loading of the creek. To accomplish the goal of reducing soil loss and improving water quality, Growing Green Communities has worked with the Iowa Department of Natural Resources to identify areas of concentrated flow paths (CFPs) within the Camp Creek Watershed using LiDAR topographic mapping technology. A goal of this project is to identify sites expected to have the greatest impact in reducing soil loss and to install Best Management Practices (BMPs) at these sites. Landowners and other project partners will work to develop the most effective BMPs for each site. After the BMPs are designed and constructed, a conservation easement will be recorded to protect the BMPs. GGC plans to record 40 acres as easements. The easements will be purchased by Growing Green Communities and donated to a qualified conservation organization for long term management and maintenance.

Final Report of Emergency Services Interim Study Committee, February 2007

The Legislative Council established the Emergency Services Interim Study Committee in 2006 and authorized the Committee to meet for two days during the 2006 Legislative Interim. Upon request by the Committee, the Legislative Council subsequently approved a third meeting. The Committee was charged to study the governance, structure, and funding of the state's emergency services and available training for emergency services providers, and receive input from the Department of Public Defense's Division of Homeland Security and Emergency Management; Departments of Human Services, Public Health, and Public Safety, including the State Fire Marshal; and representatives of emergency services providers, including the Iowa Firemen's Association, Iowa Fire Chiefs' Association, Iowa Association of Professional Fire Chiefs, Iowa Professional Fire Fighters, Iowa Emergency Medical Services Association, and emergency room physicians.

Unmet Needs SFY 2004 Final Report, February 2005

Despite the successes of the Senior Living Program and other efforts of the Iowa Aging Network, there continue to be documented unmet needs throughout the state, in part because of general fund budget reductions. These are needs identified for elderly Iowans that the community service networks are unable to meet. The sources for this data are interdisciplinary teams with the Case Management Program for the Frail Elderly (CMPFE) and service providers under contract with the Area Agencies on Aging.

Unmet Needs SFY 2005 Final Report Version 2 10/26/2005

Despite the successes of the Senior Living Program and other efforts of the Iowa Aging Network, there continue to be documented unmet needs throughout the state, in part because of general fund budget reductions. These are needs identified for elderly Iowans that the community service networks are unable to meet. The sources for this data are interdisciplinary teams with the Case Management Program for the Frail Elderly (CMPFE) and service providers under contract with the Area Agencies on Aging.

Unmet Needs SFY 2006 Final Report, October 2006

Despite the successes of the Senior Living Program and other efforts of the Iowa Aging Network, there continue to be documented unmet needs throughout the state, in part because of general fund budget reductions. These are needs identified for elderly Iowans that the community service networks are unable to meet. The sources for this data are interdisciplinary teams with the Case Management Program for the Frail Elderly (CMPFE) and service providers under contract with the Area Agencies on Aging.

L'erreur en médecine ambulatoire: comment l'aborder. [Error in ambulatory medicine: how to deal with it?]

Medical errors compromise patient safety in ambulatory practice. These errors must be faced in a framework that reduces to a minimum their consequences for the patients. This approach relies on the implementation of a new culture without stigmatization and where errors are disclosed to the patients; this culture implies the build up of a system for reporting errors associated to an in-depth analysis of the system, looking for root causes and insufficient barriers with the aim to fix them. A useful education tool is the "critical situations" meeting during which physicians are encouraged to openly present adverse events and "near misses". Their analysis, with supportive attitude towards involved staff members, allows to reveal systems failures within the institution or the private practice.

Unmet Needs SFY 2007 Final Report, October 2007

Despite the successes of the Senior Living Program and other efforts of the Iowa Aging Network, there continue to be documented unmet needs throughout the state, in part because of general fund budget reductions. These are needs identified for elderly Iowans that the community service networks are unable to meet. The sources for this data are interdisciplinary teams with the Case Management Program for the Frail Elderly (CMPFE) and service providers under contract with the Area Agencies on Aging.